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The content includes HIPAA-protected health information warnings, confidentiality and unauthorized access restriction language, and completion rules such as answering all questions in order and using the consumer’s current status. It also defines consumer and respondent roles, collects consumer details (address and date of birth), and gathers respondent contact and caregiving/living arrangement and guardian decision-maker information.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":20,"@type":76,"position":81},"https://docshare.wps.com/document/exam/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/new-jersey-comprehensive-assessment-tool-nj-cat-version-13-april-27-2015-consumer-survey-instructions/361454/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/new-jersey-comprehensive-assessment-tool-nj-cat-version-13-april-27-2015-consumer-survey-instructions/361454.png","ImageObject",300,407,{"name":92,"@type":93},"Dipper","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-23","2026-09-23",true,{"@type":102,"interactionType":103,"userInteractionCount":39},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"What does the PHI and HIPAA warning require users to do?","Question",{"text":112,"@type":113},"The document states the site contains protected health information and that unauthorized access is forbidden, which may result in civil and criminal penalties.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"How must questions be completed to move to the next page?",{"text":117,"@type":113},"All questions on each page must be answered in order to proceed, and the survey must be completed using the consumer’s status now rather than past or future.",{"name":119,"@type":110,"acceptedAnswer":120},"Who should serve as the respondent for this assessment?",{"text":121,"@type":113},"The respondent should be the person who knows the consumer best and will complete the survey on behalf of the consumer.","https://schema.org",{"og:url":83,"og:type":124,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":126,"canonical":83},"index,follow",{"doc_id":128,"site_id":62},361454,1790452151,{"code":4,"msg":5,"data":131},{"doc_id":128,"user_id":132,"nickname":92,"user_avatar":133,"doc_module":4,"category_id":19,"category_name":20,"doc_title":65,"doc_description":67,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":39,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":139,"language":140,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":141,"faqs":142,"seo_title":143,"seo_description":67,"update_tm":144,"read_time":145,"preview_page_count":4},1374404997633,"https://ap-avatar.wpscdn.com/davatar_a8503ba1806abce46bf441b54a3ca4cd","WARNING  \nThis site contains protected health information (PHI). In accordance with the Health Insurance Portability and Accountability Act (HIPAA), unauthorized access is forbidden and may result in civil  \nand criminal penalties.  \nIMPORTANT  \nPlease take your time and consider your answers to the following questions carefully. You will be able to use the “previous page” button to return to a question during the survey if you wish to change a response. However, once you have completed this assessment and submitted your responses, you will  \nbe unable to make any further changes.  \nState Of New Jersey  \nDivision Of Developmental Disabilities  \nNew Jersey Comprehensive Assessment Tool (NJ CAT)  \nConducted by Rutgers University  \nDevelopmental Disabilities Planning Institute (DDPI)  \nVersion 1.3 April 27, 2015  \nDDPI has been asked by the New Jersey Division of Developmental Disabilities (DDD) to obtain information on [name], who is applying for services. Security measures have been taken to safeguard  \nthe confidentiality of the information provided.  \nInstructions for completing the survey:  \n1. The person who knows [name] best should be the respondent.  \n2. You must answer ALL questions on each page in order to proceed to the next page.  \n3. Questions should be answered based on the consumer’s status NOW, not at some point in the past or future.  \n4. This survey will take approximately 30-40 minutes to complete.  \n5. If you have any questions about how to respond to a question, please contact us before submitting the completed survey.  \nThank you for your time and assistance with this important endeavor.  \nCONSUMER DETAILS  \nThe consumer is the person who is or may receive DDD services.  \nMIS_D) MIS/Serial: (pre-populated field)  \nCLName_D) Consumer’s First Name: (pre-populated field)  \nConsumer’s Last Name: (pre-populated field)  \nThis survey is for [Consumer’s First Name (pre-populated field) / Consumer’s Last Name (pre-populated field) / DDD ID \\# (pre-populated field)] . If this is not the correct person, please exit this survey now.  \n1. Please review the following information and correct any misspellings.  \nAgain, if this is not the correct person, please exit this survey now  \nConsumer’s First Name: (pre-populated field)  \nConsumer’s Last Name: (pre-populated field)  \n1_Cons) Please provide [firstname lastname]'s current address and date of birth in the boxes below:  \n1_Cons _ 1. Permanent Street Address:   1_Cons _2. City:   1_Cons _3. State:   1_Cons _4. Zip Code:   1_Cons _5. Date of Birth (Please use mm/dd/yyyy format.):    \n[Only ask VerifyDOB if the answer to 1_Cons_ 5 does not match file data]  \nVerifyDOB) On the previous page you indicated that [firstname lastname]'s date of birth is mm/dd/yyyy. If this is not correct, please enter the correct information below.  \n_______  \nRESPONDENT DETAILS  \nThe respondent is the person who is completing this assessment on behalf of the consumer.  \n1a. Who will be filling out the information in this survey?  \n1. Respondent on the behalf of the consumer  \n2. Consumer 􀃎 Go To Question 3b  \n1_Resp) Please provide the following information about the respondent:  \n1_Resp _ 1. Your First Name:   1_Resp _2. Your Last Name:   1_Resp _3. Your Phone Number (Please use xxx-xxx-xxxx format):   1_Resp _4. Your Cell/Alternate Phone Number (Please use xxx-xxx-xxxx format):   1_Resp _5. Your Email Address ([e.g. abcdef@ghij.com](e.g. abcdef@ghij.com)):   1_Resp _6. Your Street Address:   1_Resp _7. Your City:   1_Resp _8. Your State:   1_Resp _9. Your Zip Code:    \n2. Are you the primary caregiver for [name]? The primary caregiver is the person who is principally responsible for the care and well-being of [name] .  \n(Note: If you equally share caretaking with a spouse or other person, please answer “Yes.”)  \n0. No  \n1. Yes  \n3a. Does [name] currently live with you?  \n0. No  \n1. Yes  \n3b. What best describes [name]’s current living arrangement?  \n1. At home alone  \n2. In a home with family ","cbCaiiYptS3qZTyL","https://ap.wps.com/l/cbCaiiYptS3qZTyL","pdf",664214,35,"English","# Instructions and compliance notices\n## PHI warning and completion rules\n# Consumer details and verification\n## Consumer role definition\n## Address and date of birth fields\n## Verify date of birth step\n# Respondent details and living arrangements\n## Respondent identity and contact information\n## Primary caregiver and living arrangement questions\n## Relationship and demographic questions","[{\"question\":\"What does the PHI and HIPAA warning require users to do?\",\"answer\":\"The document states the site contains protected health information and that unauthorized access is forbidden, which may result in civil and criminal penalties.\"},{\"question\":\"How must questions be completed to move to the next page?\",\"answer\":\"All questions on each page must be answered in order to proceed, and the survey must be completed using the consumer’s status now rather than past or future.\"},{\"question\":\"Who should serve as the respondent for this assessment?\",\"answer\":\"The respondent should be the person who knows the consumer best and will complete the survey on behalf of the consumer.\"}]","New Jersey Comprehensive Assessment Tool (NJ CAT) - Version 1.3 - April 27, 2015 - Consumer Survey Instructions | PDF",1790144379,88]